Platelet rich plasma vs shock wave vs corticosteroids for plantar fasciitis

NewsBot · Dec 25, 2024

Role of corticosteroid (Methyl Prednisolone
Injection) Versus Platelet Rich Plasma (PRP) in
Treatment of Plantar Fasciitis
Dr. Govind Sharma et al
Source

Introduction: Plantar fasciitis (PF) is not an uncommon cause of heel pain whose treatment is not yet standardized.
Although platelet rich plasma (PRP) and corticosteroid (CS) injections are the two commonly used modalities, yet not much
importance has been given to the comparison of their roles in sustained functional improvement.
Aim: To study the effect of PRP and CS injections in PF and compare their effectiveness with respect to pain relief and
improvement of functional and patient satisfaction.
Material & methods: 50 cases were randomized into two groups: 25 patients (Group A) received a single injection of
autologous PRP and 25 in Group B received a single injection of CS (40 mg of methylprednisolone) by the random
selection. A structured home exercise program was demonstrated to both the groups, as baseline management. The
effectiveness was assessed and compared in pre-injection and post-injection at 3 and 6 months follow-up. Visual Analog
Scale (VAS), Roles and Maudsley (RM), and Foot Function Index (FFI) scoring systems were used as outcome measures.
Results: Mean ± SD of age was calculated to be, 42.31 ± 7.6 for Group A and 42.29 ± 8.0 for Group B. Most of the
participants in Group A [16 (64%)] & in Group B [15 (60%)] were females Mean VAS score at different follow up time
reveals, at 3rd month (Mean VAS 3.05 & 4.82 in group A & B respectively) and 6th month later (Mean VAS 1.67 & 4.12 in
group A & B respectively) follow up period, significant improvement was found in group A. There was a significant
improvement of FFI and RM score as well as at 6 months follow‑up (P = <0.001).
Conclusion: Injection of CS had an early effect, which is not sustainable, whereas PRP was found to have a prolonged
impact on pain relief and better pat
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NewsBot · Jan 3, 2025

Rock, paper, scissors: Resolving the conflicting results of randomized trials involving corticosteroid, platelet rich plasma (PRP) and placebo injections
John W. Orchard
JSAMS Plus Volume 5, June 2025, 100081

Objective
To explore whether there is evidence of a rock-paper-scissors phenomenon in injections for various musculoskeletal conditions whereby platelet rich plasma (PRP) injections outperform corticosteroid injections (CSI) in randomized trials, corticosteroid outperforms placebo whereas PRP does not outperform placebo.
Methods
Narrative review searching for examples of musculoskeletal conditions which have high level evidence of this proposed rock-paper-scissors phenomenon.
Results
High quality studies or reviews could be found for lateral epicondylitis (tennis elbow), knee osteoarthritis, rotator cuff tendinopathy and plantar fasciitis suggestive of a rock-paper-scissors phenomenon. This was consistently in the direction of PRP injections having superior results to corticosteroid injections, corticosteroid injections having superior results to placebo, but then evidence that PRP injections were not superior to placebo. The most consistent result of the triumvirate was that PRP injections consistently outperformed corticosteroid injections in the medium-term (4 to 12 months).
Discussion
There appears to be somewhat of a rock-paper-scissors phenomenon for four common musculoskeletal conditions, with the significant limitation that this was a finding of a narrative review, limited by a non-systematic search protocol. The underlying explanation is that PRP is superior to corticosteroid in the medium-term (but not the short-term), corticosteroid is superior to placebo in the short-term (only) with PRP not being superior to placebo in either short- or medium-term in well-blinded trials. The most likely explanation for this phenomenon is that corticosteroid injections are helpful for musculoskeletal conditions in the short term (≤8 weeks) but are actually harmful in the medium-term (3 months and beyond). Systematic reviews which further explore this phenomenon are justified to help provide practical evidence-based advice on when to, if ever, use PRP and corticosteroid injections for musculoskeletal conditions.
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NewsBot · Jan 7, 2025

PRP Injections for the Treatment of Knee Osteoarthritis: The Improvement Is Clinically Significant and Influenced by Platelet Concentration: A Meta-analysis of Randomized Controlled Trials
Alessandro Bensa, MD, et al
Source

Background:
Platelet-rich plasma (PRP) has emerged as a promising therapeutic intervention for knee osteoarthritis (OA), attracting substantial clinical and research attention. However, the clinical relevance of the treatment benefit remains controversial.
Purpose:
To evaluate the effectiveness of PRP compared with placebo in patients with knee OA in terms of minimal clinically important difference (MCID) and to investigate the possible influence of platelet concentration on the clinical outcome.
Study Design:
Meta-analysis. Level of evidence 1.
Methods:
The search was conducted on 5 databases (PubMed, Cochrane Library, Scopus, Embase, Web of Science) using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were randomized controlled trials comparing PRP and placebo injections to treat knee OA, written in the English language, with no time limitation. The effects were quantified at 1-, 3-, 6-, and 12-month follow-up points. Visual analog scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used, with subanalyses based on platelet concentration performed using a 1,000,000 ± 20% platelets/µL cutoff. The MCID values (VAS, 1.37; WOMAC, 6.4) were used to interpret clinical improvement. The articles’ quality was assessed using the Revised Tool for Risk of Bias in Randomized Trials and the Grading of Recommendations Assessment, Development and Evaluation guidelines.
Results:
Among the 5499 articles retrieved, 18 randomized controlled trials (1995 patients) were included. PRP presented statistically superior improvements in VAS and WOMAC scores compared with placebo at all follow-up points, exceeding the MCID at 3- and 6-month follow-up points for VAS and at all follow-up points for WOMAC. The subanalysis based on platelet concentration showed that high-platelet PRP provided clinically significant pain relief with the improvement exceeding the MCID compared with placebo at 3-, 6-, and 12-month follow-up points. In contrast, low-platelet PRP failed to offer a clinically perceivable benefit in terms of VAS score. WOMAC results showed that both products provided a clinically significant improvement at 3 and 6 months of follow-up. This benefit was maintained up to the 12-month follow-up in the high-platelet group but not in the low-platelet group, where the improvement compared with placebo did not reach statistical significance.
Conclusion:
This meta-analysis showed that PRP offered clinically relevant functional improvement at 1-, 3-, 6-, and 12-month follow-up points and pain relief at 3- and 6-month follow-up points compared with placebo for the treatment of knee OA. Platelet concentration was found to influence treatment efficacy, with high-platelet PRP providing superior pain relief and more durable functional improvement compared with low-platelet PRP.
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NewsBot · Feb 18, 2025

Ultrasonography-Guided Dextrose Prolotherapy Versus Platelet-Rich Plasma Injections for the Treatment of Plantar Fasciitis: A Randomized Controlled Trial
Neelam Kumari et al
Cureus. 2025 Jan 16;17(1):e77566.

Introduction: Heel pain is prevalent in foot and ankle practice, with plantar fasciitis being a common cause of chronic heel pain in adults. It is a degenerative condition of the plantar fascia, rendering the term fasciitis inaccurate. The condition has several alternative names, including painful heel syndrome and heel spur syndrome. It is found that a significant number of people suffer from plantar fasciitis at some stage of their lives; athletes and women between 40 and 60 years and adults aged more than 65 suffer the most. Patients typically report tenderness at the medial aspect of the heel, and pain is mostly under the surface of the heel, especially with initial morning steps. Plantar fasciitis is predominantly unilateral. Treatment options include prolotherapy and platelet-rich plasma (PRP), with this randomized controlled trial (RCT) aiming to evaluate the efficacy of PRP versus 25% dextrose prolotherapy in alleviating plantar fasciitis symptoms.

Aims and objectives: This study aimed to assess the comparative effectiveness of USG-guided 25% dextrose prolotherapy and autologous PRP injections on pain intensity, foot function, and ankle outcomes in plantar fasciitis cases.

Methodology: The study took place at the Department of Physical Medicine and Rehabilitation (PMR), King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India, with eligible patients evaluated. Group A received 25% dextrose prolotherapy, while Group B was administered autologous platelet-rich plasma. Outcome measures, including pain by Pain Intensity Scale (PIS) and assessment of disability by Foot Function Index (FFI) and Foot and Ankle Outcome Score (FAOS), were assessed at baseline and the third and sixth weeks after intervention.

Results: A total of 44 patients were randomized into two groups of 22. Group A received dextrose prolotherapy, while Group B was treated with PRP injections as per the study protocol. The average age of participants in our study was 36.10±10.0 years. Female participants were more affected than male participants in both groups. Overall, the male-female ratio was 38.6:61.4, while in Group A and Group B, this ratio was 45.5:54.5 and 31.8:68.2, respectively. The presentation of plantar fasciitis was bilateral (40.9%), on the right side (40.9%), and on the left side (18.2%). The right side was more frequently involved than the left side of the plantar fascia. There was a decrease in the average PIS score of Groups A and B at the baseline, which was 7.27±1.24 and 7.55±1.26, respectively, which was reduced to 3.18±1.30 and 2.50±0.67 after six weeks of follow-up. The average FFI score of Groups A and B at the baseline was 98.64±17.68 and 95.36±19.01, respectively, which was reduced to 79.77±12.77 and 63.77±18.50 after six weeks of follow-up. The average FAOS score of Groups A and B at the baseline was 71.36±13.95 and 74.86±28.72, respectively, which was reduced to 74.86±28.72 and 42.09±5.03 after six weeks of follow-up.

Conclusion: Both 25% dextrose prolotherapy and PRP injections are effective treatments for plantar fasciitis. Both are minimally invasive and safe treatments for plantar fasciitis.
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NewsBot · Mar 6, 2025

Platelet-Rich Plasma Versus Corticosteroids in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-Analysis
Zuo, Ankai et al
American Journal of Physical Medicine & Rehabilitation ():10.1097/PHM.0000000000002677, January 8, 2025. | DOI: 10.1097/PHM.0000000000002677

Objective
This study aims to compare the efficacy of platelet-rich plasma (PRP) and corticosteroids (CS) in treating plantar fasciitis, focusing on pain relief, foot function, and plantar fascia thickness to identify the optimal treatment approach.

Design
A comprehensive search of medical databases was conducted following PRISMA guidelines, utilizing an extensive keyword strategy. Inclusion criteria encompassed prospective RCTs involving adult patients with plantar fasciitis treated with local PRP or CS injections, specifically assessing outcomes such as the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) scores, and plantar fascia thickness.

Results
The meta-analysis included 24 RCTs with 1653 participants. PRP injections yielded significantly better VAS scores compared to CS injections at 3 months (P = 0.03) and 6 months (P < 0.001), with no significant differences at 1 month (P = 0.12) and 12 months (P = 0.08). AOFAS scores demonstrated that PRP was superior to CS at 3 (P = 0.05), 6 (P < 0.001), and 12 months (P < 0.001), with no significant differences at 1 month (P = 0.31). Regarding plantar fascia thickness, there were no significant differences between PRP and CS at 1-1.5 months (P = 0.18), 3 months (P = 0.64), and 6 months (P = 0.05).

Conclusions
PRP injections offer superior pain control compared to corticosteroids in the medium term (3-6 months) but not in the short term or at one year.
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NewsBot · Apr 24, 2025

To Evaluate Efficacy of Intralesional Platelet Rich Plasma in Patients with Plantar Fasciitis
Sanjiv Kumar et al
J Am Podiatr Med Assoc. 2025 Apr 23:1-24.

Background: Plantar fasciitis (PF) is one of the most common causes of heel pain that affecting 10 % of the general population. Platelet rich plasma (PRP) has been demonstrated to be helpful in managing PF and reducing plantar facia thickness (PFT). This study objective was to know the effect and efficacy of ultrasound (USG) guided intralesional PRP in PF in relation to pain, PFT and foot function index (FFI).

Methods: A prospective interventional study was conducted in a tertiary care hospital on eighty-five diagnosed cases of unilateral PF. All patients had undergone pain intensity assessment by visual analogue scale (VAS), FFI, and USG examination of PFT after USG guided intralesional PRP injection was assessed at baseline (0 weeks), 2 weeks and 6 weeks.

Results: Following USG guided intralesional PRP injection, a statistically significant decrease was noted in plantar fascia thickness (PFT) from baseline 0 (week) 6.592mm ± 0.51mm to 5.169mm ± 0.39mm and reduced to 4.07mm ± 0.39mm at 2nd week and 6th week, respectively (P value < 0.001). A statistically significant reduction of VAS score was noted which reduced from 8.647 ± 0.55 to 5.588 ± 1.13 (2nd week) and further reduced to 1.21 ± 1.06 at the end of 6 weeks (p value < 0.001). Mean FFI in our study at baseline was 85.494 ± 6.55, at 2 weeks mean FFI was 49.341 ± 7.277 and the end of 6 week it reduced to 24.235 ± 1.608 (P value < 0.001) statistically significant decrease was noted.

Conclusions: PRP injection helps in the reduction of heel pain (VAS), reduction in PFT, and improvement in all domains of FFI, leading to enhancement of quality of life.
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NewsBot · Jun 6, 2025

Chronic plantar fasciitis: which is more effective? Prolotherapy/extracorporeal shock wave therapy? A randomized controlled trial
Ayşe Ukbe Baykut et al
Arch Orthop Trauma Surg. 2025 Apr 12;145(1):242. doi: 10.1007/s00402-025-05859-z.

Introduction / aim: Chronic plantar fasciitis is a prevalent musculoskeletal disorder. The objective of this study was to compare the effects of ESWT and prolotherapy on pain, foot function, plantar fascia thickness and plantar pressure distribution in patients with chronic plantar fasciitis.

Materials and methods: A total of 70 patients were included in this prospective, randomised controlled study. The patients were randomly assigned to one of two groups. The study population was divided into two groups: the ESWT group (n = 36) and the prolotherapy group (n = 34). In the ESWT group, a total of 1800 to 2000 focused shock waves (0.15-0.25 mJ/mm² sessions with a frequency of 3-4 Hz) were applied. The prolotherapy group was administered a 3-ml injection of a 15% dextrose solution. The ESWT and prolotherapy treatments were administered in a total of three sessions, with two-week intervals between each session. The efficacy of the treatment was evaluated using a number of different measures, including the Visual Analogue Scale (VAS), the Foot and Ankle Ability Measurement (FAAM), the thickness of the plantar fascia and the distribution of plantar pressure. The evaluations were conducted at the outset of the study, at the six-week mark, and at the 12-week mark following the final intervention.

Results: In both groups, there was a statistically significant reduction in morning VAS value and plantar fascia thickness at week 12 compared to baseline (p < 0.001). The difference between the groups was only in plantar fascia thickness at week 6 and overall VAS value at week 12.

Conclusion: Prolotherapy was found relatively more effective than ESWT in reducing VAS value in the medium term (3 months), although there is no difference in functional parameters. The results demonstrated that both prolotherapy and ESWT exhibited comparable outcomes during the follow-up period.
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NewsBot · Jun 13, 2025

Comparative Effectiveness of Ultrasound-Guided Corticosteroid Injection and Radial Extracorporeal Shock Wave Therapy for Plantar Fasciitis: A Double-Blind Randomized Controlled Trial
P. Aiswarya, Keshav Dev, Mukesh Kumar Yadav, Neethu Sunilkumar, Mrinal Joshi & Astha Patni
Indian Journal of Orthopaedics

Introduction
Plantar fasciitis (PF) is one of the most prevalent causes of heel pain, involving inflammation of the plantar fascia leading to pain and functional disability. The treatment options of PF include conservative, minimally invasive procedures, and surgery. Of these, radial extracorporeal shock wave therapy (rESWT) and corticosteroid injections (CSI) are widely practised treatments for PF, but its treatment outcome is often debated. Understanding the treatment course, symptom improvement rate, and cure of the underlying pathology is always essential to choose a treatment modality. This study is aimed to evaluate the early effectiveness of ultrasound-guided CSI and rESWT in the treatment of PF.

Methodology
A hospital-based, randomized, double-blind interventional study was conducted in our tertiary center to evaluate the efficacy of CSI and rESWT in participants presenting with plantar heel pain. A total of 170 participants were enrolled and randomly assigned to either the CSI or rESWT group. After treatment completion, follow-up was completed in the 70 participants in each group. The CSI group received an injection comprising 2 mL of methyl prednisolone acetate (40 mg/mL) combined with 2 ml of 2% lignocaine, while the rESWT group received 2000 shock impulses at a pressure of 2.5 bars and a frequency of 15 Hz for three consecutive weeks. The participants were assessed at baseline (week 0), 4 weeks, and 8 weeks post-treatment as this study is aimed to focus mainly on the early outcome of both primary modalities. Outcome measures included the visual analogue scale (VAS) at three instances of a day such as ‘first step in the morning’, ‘at rest’ and ‘during activities of daily living’ for pain assessment, the Foot and Ankle Ability Measure (FAAM) with Activities of Daily Living (ADL) and Sports subscales for functional evaluation, and ultrasonographic measurement of plantar fascia thickness.

Results
After 4 weeks and 8 weeks, VAS score continued to decrease in all the three time instances in the CSI group, whereas even though it started reducing for rESWT at 4 weeks, pain with respect to VAS score showed an increasing trend by 8 weeks. By 4 weeks, significant differences appeared within the CSI group compared to rESWT in all three instances. By 8 weeks, these differences became even more pronounced and statistically significant (p < 0.05). In terms of the FAAM scale, both groups showed increase in the score, where a higher score indicates better function. CSI resulted in more significant improvement in terms of ADL (p = 0.0001) and Sports subscale (p = 0.01). rESWT, while showing some improvement, was less effective than CSI, especially in the ADL subscale at 8 weeks. In terms of plantar fascia thickness, both groups showcased reduction in thickness, but there was no statistically significant difference between the two groups at 4 weeks (p = 0.163). At 8 weeks, the study showed a statistically significant difference between the two groups (p = 0.042). At this point of time, the reduction in plantar fascia thickness appeared to be greater in CSI compared to the rESWT group.

Conclusion
The study indicates that ultrasound-guided CSI and rESWT are both effective in PF treatment, where CSI is more effective with immediate recovery and progressive symptom improvement in contrast to the rESWT.
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NewsBot · Jun 22, 2025

A Comparative Study of Platelet-Rich Plasma V/S Corticosteroid Injection for Plantar Fasciitis
Shah, Het; Prabhakaran, A; Praveen, Iyyappan; Farook, Umar
Journal of Pharmacy and Bioallied Sciences 17(Suppl 2) S1689-S1691, June 2025. | DOI: 10.4103/jpbs.jpbs_263_25

Background:

Plantar fasciitis, a chronic inflammatory condition characterized by heel pain, significantly impacts daily functioning. While corticosteroid injections are a common treatment, they are associated with limitations such as short-term efficacy and potential complications.
Materials and Methods:

This prospective interventional study was conducted at Mahatma Gandhi Medical College and Research Institute, Puducherry, between August 2022 and May 2024. A total of 60 patients diagnosed with plantar fasciitis, aged 18–70 years, were randomly divided into two groups: the platelet-rich plasma (PRP) group (30 patients) and the corticosteroid group (30 patients). PRP therapy was administered using the peppering technique, while the corticosteroid group received 80 mg methylprednisolone injections. Pain and functional outcomes were assessed at baseline, second, fourth, eighth, and 12th weeks using the visual analog scale (VAS) and Foot and Ankle Ability Measure (FAAM).
Results:

The mean age of participants was 47.30 ± 10.75 years in the PRP group and 46.13 ± 10.58 years in the corticosteroid group. Females constituted 53.3% of the PRP group and 60% of the corticosteroid group. Significant reductions in VAS scores were observed in the PRP group compared to the corticosteroid group at the second week (5.53 ± 0.776 vs. 6.47 ± 0.937, P < 0.001), fourth week (4.70 ± 0.466 vs. 5.27 ± 0.868, P = 0.003), and 12th week (2.10 ± 0.712 vs. 2.77 ± 0.858, P = 0.002). Functional improvement, measured by FAAM scores, was significantly greater in the PRP group at the 12th week (91.03 ± 3.943 vs. 86.13 ± 6.388, P = 0.001).
Conclusion:

PRP therapy is a superior alternative to corticosteroid injections for the management of plantar fasciitis, providing sustained pain relief and improved functional outcomes over a 12-week period. Further large-scale, long-term studies are recommended to validate these findings.
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NewsBot · Jun 26, 2025

Comparative efficacy of various treatment modalities for plantar fasciitis
Hind Bakadir , Kawtar Nassar , Ilham Jebbouje , Soukaina Zaher , Ahlam Ajerouassi , Wafae Rachidi , Saadia Janani
Rheumatology, Volume 64, Issue Supplement_3, April 2025, keaf142.286, https://doi.org/10.1093/rheumatology/keaf142.286

Background/Aims
Plantar fasciitis is a common condition resulting from inflammation of the plantar fascia. Several therapeutic options are available, including corticosteroid injections, anti-inflammatory medications, orthotic insoles, and shockwave therapy. However, the comparative efficacy of these treatments remains poorly defined. The aim of this study is to compare the effectiveness of various treatment modalities for plantar fasciitis, based on the evolution of pain and foot function, measured respectively by the Visual Analog Scale (VAS) and the Foot Function Index (FFI).

Methods
This is a descriptive retrospective study conducted in the rheumatology department of CHU IBN ROCHD over a three-year period from January 2021 to January 2024. Inclusion criteria were patients diagnosed with plantar fasciitis confirmed by ultrasound. Data were collected from the HOSEALTH database of the rheumatology department.

Results
Thirty patients, with an average age of 53 years, were included. The male-to-female ratio was 0.5. The average Body Mass Index (BMI) was 24.1 kg/m². Patients presented with either unilateral or bilateral plantar fasciitis, with a progressive course, and their physical activity levels varied from moderate to vigorous. Treatment modalities included corticosteroid injections for 78% of patients, shockwave therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and orthotic insoles. Corticosteroid injections resulted in a significant reduction in pain, with a VAS score decreasing from 7 to 1 after three months. The FFI indicated substantial improvements in pain, function, and activity limitations. Shockwave therapy reduced the VAS score from 7 to 4 over three months. The use of NSAIDs decreased the VAS score from 7 to 4 after three months. Finally, orthotic insoles, when combined with local NSAIDs, reduced the VAS score from 7 to 3 after three months, accompanied by improvements in the FFI.

Conclusion
Corticosteroid injections and orthotic insoles combined with NSAIDs are the most effective treatments for plantar fasciitis, significantly improving pain and function in patients. This study provides useful data to assist in the management of this condition, highlighting the effectiveness of injections and orthotic devices. However, the sample size remains a limitation of the study. Further evaluations with longer follow-up and a larger sample size are necessary to confirm these results.
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NewsBot · Jun 29, 2025

Platelet-rich plasma and corticosteroid injection for tendinopathy: a systematic review and meta-analysis
Zifeng Ye et al
BMC Musculoskelet Disord. 2025 Apr 8;26(1):339.

Objective: In this systematic review and meta-analysis, we evaluated and compared the efficacy and safety of platelet-rich plasma injection into corticosteroid injection in the treatment of tendinopathy.

Methods: We searched PUBMED, EMBASE, Cochrane Library, SCOPUS, and Web of Science to identify randomized controlled trials on the PRP injection versus CS injection in treatment of tendinopathy.The meta-analysis was performed using the Revman 5.4 software.

Result: We found 27 RCT studies with a total of 1779 patients enrolled. 8 rotator cuff injuries, 7 humeral external epicondylitis, 10 plantar fasciitis, and 2 tenosynovitis. The results of the meta-analysis showed that there were no significant group differences in the results of patients with rotator cuff injury comparing the pain visual analog scale score and functional measures at 1 month after receiving injection treatment. After three months of receiving PRP treatment, the VAS scores showed greater improvement compared to the CS group(OR = -1.64,95%CI [-2.97,-0.31],P = 0.02), while there was no statistically significant difference in shoulder joint function between the two groups at the 3-6 month post-treatment mark. Patients with plantar fasciitis showed no significant differences in VAS and AOFAS scores after receiving PRP or CS injections at 1 and 3 months. However, at the 6-month mark, the PRP group demonstrated significantly better VAS and AOFAS scores compared to the CS group(OR = -1.41,95%CI [-1.88,-0.44],P < 0.00001; OR = 7.19,95%CI [2.41,11.91],P = 0.003). 1 month after CS injection in patients with tenosynovitis, the VAS score was lower than that of the PRP group; patients with elbow epicondylitis had better improved upper limb function rating scale scores 1 month after CS injection compared to the PRP group. In patients with tenosynovitis, the VAS scores were superior to the CS group six months after PRP treatment(OR = -0.72,95%CI [-1.04,-0.40],P < 0.00001); similarly, patients with lateral epicondylitis exhibited better VAS, DASH scores than the CS group three and twelve months post-PRP treatment(OR = -9.76,95%CI [-10.89,-8.63],P = 0.0002; OR = -0.97,95%CI [-1.87,-0.06],P < 0.0001; OR = -18.03,95%CI [-31.61,-4.46],P = 0.009).

Conclusion: PRP can effectively improve pain and functional impairment in patients with tendinopathy, and its mid-term efficacy is superior to that of corticosteroids. However, the long-term efficacy remains to be further clinically verified.
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NewsBot · Jul 1, 2025

Comparative Effectiveness of Platelet-Rich Plasma and Steroid Injections in Chronic Plantar Fasciitis: Evaluating Pain Relief and Functional Recovery
Ömer Faruk Bucak et al
Source

Background:
Chronic plantar fasciitis (CPF) is a prevalent cause of heel pain, often refractory to conservative treatments. Corticosteroid injections (CSIs) are frequently used for symptom relief but may provide only transient benefits and are associated with potential adverse effects. Platelet-rich plasma (PRP) has gained attention as an alternative because of its regenerative properties. This study compares the effectiveness of PRP injections (n = 75) and CSI (n = 77) in reducing pain and improving function over six months in patients with CPF.
Methods:
A retrospective cohort study was conducted on 152 patients diagnosed with CPF who received ultrasound-guided injection therapy at a tertiary university hospital between September 2021 and September 2024. Patients were divided into CSI (n = 77) and PRP injection (n = 75). Pain intensity was measured using the visual analog scale (VAS), and functional status was assessed with the Foot Function Index (FFI). Evaluations were performed at baseline and 1, 3, and 6 months postinjection.
Results:
At baseline, VAS (P = .449) and FFI (P = .462) scores were comparable between groups. At 1 month, no significant differences were found for VAS (P = .368) and FFI (P = .392). At 3 months, VAS (P = .586) and FFI (P = .578) scores remained similar. At 6 months, PRP showed significantly lower VAS scores (1.98 ± 0.35) compared with corticosteroids (2.79 ± 1.13; P < .001); however, the difference did not exceed the MCID threshold (0.9 cm), suggesting limited clinical significance. Conversely, FFI scores improved more in the PRP group (22.3 ± 4.1) than in the corticosteroid group (29.8 ± 5.5; P < .001), exceeding the MCID threshold (7 points), confirming clinical relevance.
Conclusion:
PRP injections were associated with superior 6-month functional improvement over corticosteroids in CPF, with statistically significant gains that met the MCID threshold. Although both treatments were effective in the short term, only functional improvements reached clinical significance. These findings support PRP’s role in providing a modest functional advantage and highlight the need for future trials to optimize injection protocols and assess long-term outcomes.
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NewsBot · Jul 1, 2025

Comparison between Steroid Injections versus Conservative Therapy in the Treatment of Plantar Fasciitis
Huzaifa Tariq et al
Indus Journal of Bioscience Research

Introduction: Plantar fasciitis can be treated with several approaches as of yet. Common treatments can be divided into non-invasive treatments, such physical therapy (PT), orthosis, oral NSAIDs, radiation therapy (RT) and shock wave (SW) and invasive treatments, such corticosteroid injection (CSI), botulinum toxin injection, platelet-rich plasma (PRP) injection and surgery. So, this study is being undertaken to compare non- invasive conservative methods versus local Steroid injection therapy. The technique with better results will be recommended in future to reduce morbidity of these patients. Materials and Procedures: 434 patients in all fulfilling the inclusion criteria were chosen. Using computer produced random number tables, all of the study participants—who had informed written permission—were randomly divided into two groups. Group B patients received corticosteroid injections; Group A patients underwent conservative treatment. At least four years of post-fellowship experience, a consultant orthopedic surgeon conducted the procedure. Patients had surgery, and following four weeks, fictitious outcomes based on Visual Analogue Scale were observed. Results were assessed as Excellent when VAS was 0; Good when VAS was 0–30mm; Fair when VAS was 30–60mm; Poor when VAS = 60–100mm. Results: In my study, conservative management showed treatment outcome as excellent in 57.60% patients, good in 24.42%, fair in 10.60% and poor in 7.37% patients. While 86.18% of patients receiving corticosteroid injection treatment for Planter Fasciitis had excellent outcome, 6.45% good outcome, 4.15% fair outcome and 3.23 had poor outcome. Conclusion: This study found that treating plantar fasciitis with local corticosteroid injection results in a better functional outcome than with conservative management.
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NewsBot · Jul 10, 2025

Chronic plantar fasciitis: which is more effective? Prolotherapy/extracorporeal shock wave therapy? A randomized controlled trial
Ayşe Ukbe Baykut, Handan Elif Nur Bayraktar, Hilal Buse Arslan, Elif Yalçın & İpek Poyraz
Archives of Orthopaedic and Trauma Surgery

Introduction / Aim

Chronic plantar fasciitis is a prevalent musculoskeletal disorder. The objective of this study was to compare the effects of ESWT and prolotherapy on pain, foot function, plantar fascia thickness and plantar pressure distribution in patients with chronic plantar fasciitis.
Materials and methods

A total of 70 patients were included in this prospective, randomised controlled study. The patients were randomly assigned to one of two groups. The study population was divided into two groups: the ESWT group (n = 36) and the prolotherapy group (n = 34). In the ESWT group, a total of 1800 to 2000 focused shock waves (0.15–0.25 mJ/mm² sessions with a frequency of 3–4 Hz) were applied. The prolotherapy group was administered a 3-ml injection of a 15% dextrose solution. The ESWT and prolotherapy treatments were administered in a total of three sessions, with two-week intervals between each session. The efficacy of the treatment was evaluated using a number of different measures, including the Visual Analogue Scale (VAS), the Foot and Ankle Ability Measurement (FAAM), the thickness of the plantar fascia and the distribution of plantar pressure. The evaluations were conducted at the outset of the study, at the six-week mark, and at the 12-week mark following the final intervention.
Results

In both groups, there was a statistically significant reduction in morning VAS value and plantar fascia thickness at week 12 compared to baseline (p < 0.001). The difference between the groups was only in plantar fascia thickness at week 6 and overall VAS value at week 12.
Conclusion

Prolotherapy was found relatively more effective than ESWT in reducing VAS value in the medium term (3 months), although there is no difference in functional parameters. The results demonstrated that both prolotherapy and ESWT exhibited comparable outcomes during the follow-up period.
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NewsBot · Jul 14, 2025 at 10:14 PM

A Comparative Study of Platelet-Rich Plasma V/S Corticosteroid Injection for Plantar Fasciitis
Het Shah et al
J Pharm Bioallied Sci. 2025 Jun;17(Suppl 2):S1689-S1691.

Background: Plantar fasciitis, a chronic inflammatory condition characterized by heel pain, significantly impacts daily functioning. While corticosteroid injections are a common treatment, they are associated with limitations such as short-term efficacy and potential complications.

Materials and methods: This prospective interventional study was conducted at Mahatma Gandhi Medical College and Research Institute, Puducherry, between August 2022 and May 2024. A total of 60 patients diagnosed with plantar fasciitis, aged 18-70 years, were randomly divided into two groups: the platelet-rich plasma (PRP) group (30 patients) and the corticosteroid group (30 patients). PRP therapy was administered using the peppering technique, while the corticosteroid group received 80 mg methylprednisolone injections. Pain and functional outcomes were assessed at baseline, second, fourth, eighth, and 12th weeks using the visual analog scale (VAS) and Foot and Ankle Ability Measure (FAAM).

Results: The mean age of participants was 47.30 ± 10.75 years in the PRP group and 46.13 ± 10.58 years in the corticosteroid group. Females constituted 53.3% of the PRP group and 60% of the corticosteroid group. Significant reductions in VAS scores were observed in the PRP group compared to the corticosteroid group at the second week (5.53 ± 0.776 vs. 6.47 ± 0.937, P < 0.001), fourth week (4.70 ± 0.466 vs. 5.27 ± 0.868, P = 0.003), and 12th week (2.10 ± 0.712 vs. 2.77 ± 0.858, P = 0.002). Functional improvement, measured by FAAM scores, was significantly greater in the PRP group at the 12th week (91.03 ± 3.943 vs. 86.13 ± 6.388, P = 0.001).

Conclusion: PRP therapy is a superior alternative to corticosteroid injections for the management of plantar fasciitis, providing sustained pain relief and improved functional outcomes over a 12-week period. Further large-scale, long-term studies are recommended to validate these findings.
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Platelet rich plasma vs shock wave vs corticosteroids for plantar fasciitis

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Platelet rich plasma vs shock wave vs corticosteroids for plantar fasciitis

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Platelet-rich plasma for plantar warts

Platelet rich plasma for sesamoid injuries

Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis

Intraoperative use of Platelet-Rich Plasma

Platelet-rich plasma in treatment of chronic venous leg ulcers

Platelet rich plasma for plantar plate injuries

Platelet rich plasma for fractures

Share This Page

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